Chris Buse1. 1. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Abstract
RATIONALE: Intersectoral action (ISA) has been at the forefront of public health policy discussions since the 1970s. ISA incorporates a broader perspective of public health issues and coordinates efforts to address the social, political, economic and environmental contexts from which health determinants operate and are created. Despite being forwarded as a useful way to address and treat complex or 'wicked' problems, such policy issues are still often addressed within, rather than across, disciplinary silos and ISA has been documented to fail more often than it succeeds. AIMS AND OBJECTIVES: This paper contributes to an understanding of ISA by outlining and applying critical systems heuristics (CSH) theory and methods. METHODS: CSH theory and methods are described and discussed before applying them to the example of addressing climate change and health equity through public health practice. RESULTS: CSH thinking provides useful tools to engage stakeholders, question relations of power that may exist between collaborating partners, and move beyond power inequalities that guide ISA initiatives. CONCLUSIONS: CSH is a compelling framing that can improve an understanding of the collaborative relationships that are a prerequisite for engaging in ISA to address complex or 'wicked' policy problems such as climate change.
RATIONALE: Intersectoral action (ISA) has been at the forefront of public health policy discussions since the 1970s. ISA incorporates a broader perspective of public health issues and coordinates efforts to address the social, political, economic and environmental contexts from which health determinants operate and are created. Despite being forwarded as a useful way to address and treat complex or 'wicked' problems, such policy issues are still often addressed within, rather than across, disciplinary silos and ISA has been documented to fail more often than it succeeds. AIMS AND OBJECTIVES: This paper contributes to an understanding of ISA by outlining and applying critical systems heuristics (CSH) theory and methods. METHODS: CSH theory and methods are described and discussed before applying them to the example of addressing climate change and health equity through public health practice. RESULTS: CSH thinking provides useful tools to engage stakeholders, question relations of power that may exist between collaborating partners, and move beyond power inequalities that guide ISA initiatives. CONCLUSIONS: CSH is a compelling framing that can improve an understanding of the collaborative relationships that are a prerequisite for engaging in ISA to address complex or 'wicked' policy problems such as climate change.